Pediatric interventional radiology

Chaudry, Gulraiz

doi:10.4102/sajr.v20i1.940

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…Addressing anastomotic strictures and intrahepatic stones has been an ongoing problem. Where available, interventional radiological techniques have been used to dilate and stent anastomotic strictures [14][15][16]. Failed RYBD often requires major repeat laparotomies or interventional radiology procedures [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…Other alternates that have been used were the gallbladder, an ileal loop between the hepatic duct and jejunum, and an isolated vascularized jejunal tube that has also been successfully used in an animal study [1,3,4]. Interventional radiology procedures are paramount for addressing complications of RYBD [14,15,24]. Paediatric interventional radiology is a scarce resource, with few specialists practising in the developing world [6,7].…”

Section: Discussionmentioning

confidence: 99%

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Isolated vascularized gastric tube biliary enteric drainage: a paediatric case series experience

et al. 2021

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Background Despite the enormous surgical advancements in the last century, access to the biliary system is lost when a Roux-en-Y (RY) biliary drainage procedure is performed. Attempts have been made to overcome this inconvenient sequel using variations in the RY anastomosis, small bowel grafts and vascular grafts. These have been predominantly unsuccessful. An isolated vascularized gastric tube (IVGT) graft has been reported in the literature, which was successfully used for adult patients with common bile duct injuries. We have adopted the technique of using an IVGT graft for bile duct reconstruction in the paediatric patients at our institution. We reviewed our experience at our institution between January 2015 and October 2019. This was a retrospective review of all paediatric patients undergoing an IVGT graft procedure for biliary tract anatomical obstruction in the past 5 years. We looked at the indications for surgery, the demographic profile of the patients and outcomes following surgery and outlined the surgical technique used. Results IVGT bile duct reconstruction was performed on eight patients. Patients ranged from 2 months to 7 years, and there was an equal number of males and females. The diagnosis was made on clinical suspicion and confirmed with ultrasound (U/S) and magnetic resonance cholangiopancreatography (MRCP). There was an 87.5% resolution of biliary obstruction, and two patients who had bile leaks postoperatively were managed conservatively. Unfortunately, one patient died in the early postoperative period from sepsis due to pneumonia. Follow-up was for a minimum of 6 months and up to 5 years. Conclusion IVGT biliary enteric drainage is a safe, reproducible procedure that allows access to the biliary tree if required in the future. Thus, this procedure serves as an alternative, especially in limited-resource areas where interventional radiology is not available for future interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Isolated vascularized gastric tube biliary enteric drainage: a paediatric case series experience

et al. 2021

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Local diagnostic reference levels in diagnostic and therapeutic pediatric cardiology at a specialist pediatric hospital in South Africa

Mbewe

Mjenxane

2022

Polish Journal of Medical Physics and Engineering

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Introduction: Children may be at a higher risk of experiencing the detrimental effects of ionizing radiation arising from medical radiation imaging. Dose optimisation is therefore recommended to provide assurance that their exposure is as low as reasonably achievable. To this end, periodic assessment of dose levels and establishment of Local Diagnostic Reference Levels (LDRLs) in medical facilities is necessary. There is a general paucity in the literature of data pertaining to dose levels in pediatric interventional radiology. This study establishes LDRLs in diagnostic and therapeutic heart catheterization procedures at a specialist pediatric hospital in a resource constrained country. Material and methods: Dose indicators from actual patient procedures were collected from the archive and analyzed retrospectively to determine the median, 25th, and 75th percentiles of the total Air Kerma Area Product (KAP), Cumulative Air Kerma (CAK), total Fluoroscopy Time (FT), and a total number of Cine Images (CI) of selected interventional procedures. The dose indicators were also age-stratified into five age groups defined by the International Commission on Radiation Protection publication 135. The results were compared to values available from similar studies in the literature to benchmark our dose levels. Local Dose Reference Levels were set as the 75th percentile values. Results: For diagnostic procedures (n = 80), the 75th percentiles of KAP, CAK, FT, and CI were 4.0 Gy·cm2, 31.5 mGy, 14.3 min, and 315 frames, respectively and 3.2 Gy·cm2, 30.5 mGy, 17.5 min, and 606 frames, respectively for therapeutic procedures (n = 143). Conclusions: The LDRLs from this study did not vary significantly from those published in the literature, suggesting that practices at our center were comparable to international norms. Regular reviews of the LDRLs must be conducted to check that the dose levels do not deviate considerably.

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Pediatric interventional radiology

Cited by 2 publications

References 15 publications

Isolated vascularized gastric tube biliary enteric drainage: a paediatric case series experience

Isolated vascularized gastric tube biliary enteric drainage: a paediatric case series experience

Local diagnostic reference levels in diagnostic and therapeutic pediatric cardiology at a specialist pediatric hospital in South Africa

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